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Wednesday, November 9, 2011

Screening tests - good or bad

Screening tests have come a long way in recent decades. Mammograms, as an example, were virtually unknown in the 1970's and started being suggested as a way to detect breast cancer by 1980. Then they became recommended annually. Then digital technology came along so they could detect even smaller and smaller cancers. And the rate of false positives went up - causing unwanted stress and unneeded biopsies.

Now we are at a point were tests are so good they are finding small benign 'nothings' or very early stage cancers that are so slow growing, they would never be an issue.

Using this chart, you can see the risks of getting or dying from some cancers:

We talk about the tests, screenings, and costs. But if you look at the numbers, what are the chances you are going to die from it anyway? So where do you draw the line on what you test for and what you ignore? Is it really worth it to have that every ten year colonoscopy if you have no other risk factors - like family members with the colon cancer? Your risk of being diagnosed in the next 20 years, at age 40 is less than 1%. As the article states, "The average woman has a 3 percent lifetime risk of dying of breast
cancer, a low risk for a disease that women find so scary. But the
chances of getting breast cancer do gradually increase with age and
other circumstances."

I am not suggesting that we stop screening tests. I am diligent about getting them as suggested - with my medical history wouldn't you? But they are worthy of another look. The biggest killer in the US is heart disease. How do we test for that? We start with pulse and blood pressure readings which are quick and easy and can be repeated at minimal expense. But the costs of a mammogram, CT scan for lung cancer, or colonoscopy are more significant - both financially and emotionally when you add in the stress of colonoscopy prep, false positives, and unneeded biopsies.

I met a woman recently who had cancer. She said she would be out of touch for a few days as she was going to have a week of screening tests. We talked about them briefly. She said she wasn't really concerned about them but that they do induce either scanxiety or scanphobia in those who have to go through them. That little clench in your gut each time you drive to the hospital for yet another one - they really start to add up over time.

How can we take care of ourselves and catch 'bad things' as early as possible? Maybe we go back to eating right, exercise, maintain a healthy weight, blah, blah, blah (where have I heard this before?). I don't know. I just get to go to the doctor all the time.

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Quotes

Don't worry about failure. Worry about the chances you miss when you don't even try.

Of all the things I've lost I think I miss my mind the most.

Flowers make me smile

Blog info

If you want to follow my story and ramblings through the medical world, you need to start reading the oldest post first which is at the very bottom or you can jump to it by going to June 2007 and look for 'My Big Announcement'. I started this blog so I could keep my friends and family up on my dealings with breast cancer but now it has evolved into my take on the medical world as well as my medical ups and downs. I have not listed my email address but if you know me, you know how to contact me. I always welcome emails. You can also find me on Twitter @carolinemfr and on Facebook. Otherwise, feel free to leave a comment!

But no I do not write about suggested topics or other people's blogs or other ailments so do not bother asking. Sorry.